{"doi":"10.1016/j.clcc.2021.09.008","title":"Impact of Relative Dose Intensity of FOLFOX Adjuvant Chemotherapy on Risk of Death Among Stage III Colon Cancer Patients","abstract":"BACKGROUND: The National Comprehensive Cancer Network (NCCN) guidelines have recommended tailored chemotherapy for stage III high-risk (T4 and/or N2) and low-risk (T1-T3 and N1) colon cancer since 2018. Studies have investigated the effect of relative dose intensity (RDI) of FOLFOX on stage III colon cancer survival, however, none has performed a stratified analysis by risk profiles. This study aims to identify the FOLFOX optimal RDI for high-risk and low-risk stage III colon cancer patients. METHODS: Data on 407 eligible patients, diagnosed with stage III colon cancer in 2011 who received FOLFOX, were collected by 8 population-based cancer registries. Multivariable Cox model and Fine-Gray competing risks model were employed to explore Optimal RDI defined as the lowest RDI administered without significant differences in either overall or cause-specific death. RESULTS: Among the 168 high-risk patients, the optimal RDI cut-off was 70% (HR = 1.59 with 95% CI: 0.69-3.66 in overall mortality; HR = 1.24 with 95% CI: 0.42-3.64 in cause-specific mortality when RDI < 70% vs. RDI ≥ 70%). Among the 239 low-risk patients, none of the evaluated cut-offs were associated with significant differences in risk of death between comparison groups. The lowest assessed RDI was 45%, HR = 0.80; 95% CI: 0.24 to 2.73 for overall mortality and HR = 0.53; 95% CI: 0.06 to 4.95 for cause-specific mortality, when RDI <45% versus RDI ≥45%. CONCLUSIONS: There is no significant harm on the risk of death when reducing RDI by <30% for high-risk patients. For the low-risk patients, we found that RDI as low as 45% did not significantly affect the risk of death.","journal":"Clinical Colorectal Cancer","year":2021,"id":193604,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9559,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":24216,"name":"Trevor Thompson","orcid":"0000-0001-9880-782X","position":1,"is_corresponding":false},{"id":467907,"name":"Hui‐Yi Lin","orcid":"0000-0002-3307-5549","position":2,"is_corresponding":false},{"id":762122,"name":"Vivien W. Chen","orcid":"0000-0001-7054-2604","position":3,"is_corresponding":false},{"id":762123,"name":"Jordan J. Karlitz","orcid":"0000-0001-5686-7365","position":4,"is_corresponding":false},{"id":107375,"name":"Elizabeth T. H. Fontham","orcid":null,"position":5,"is_corresponding":false},{"id":304817,"name":"Katherine P. Theall","orcid":"0000-0001-6371-1959","position":6,"is_corresponding":false},{"id":762124,"name":"Lu Zhang","orcid":"0000-0002-8325-2793","position":7,"is_corresponding":false},{"id":404801,"name":"Mei‐Chin Hsieh","orcid":"0000-0001-7842-1225","position":8,"is_corresponding":false},{"id":400149,"name":"Lori A. Pollack","orcid":"0000-0001-9289-0773","position":9,"is_corresponding":false},{"id":353078,"name":"Xiao‐Cheng Wu","orcid":"0000-0003-3663-5027","position":10,"is_corresponding":false},{"id":762719,"name":"Meijiao Zhou","orcid":null,"position":0,"is_corresponding":true}],"reference_count":39,"raw_metadata":null,"created_at":"2026-07-18T23:49:51.300073Z","pmid":"34756680","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}